Margin Recovery
Most Independent Practices Are Leaving $500K to $2M on the Table. We Find It and Help You Get It Back.
The problem is rarely reimbursement. It is unmanaged complexity: billing gaps, vendor contracts nobody has reviewed, scheduling patterns that quietly reduce capacity, and A/R aging that has been drifting for years. We work from your actual numbers, not surveys or assumptions.
What This Work Actually Is
I have done this work from inside the building. That means leading the A/R recovery conversations, sitting in the vendor renegotiations, redesigning the scheduling templates, and building the scorecards that hold the gains. Not delivering a report and moving on.
The practices I have worked with have recovered more than $1 million in aged charges through focused payer and A/R work, reduced overhead by double digits, cut IT expense by 40% through smarter modernization, and improved infusion margin from 7% to 20%. Those results came from execution, not analysis.
This engagement is structured as a 90 to 120 day intervention. We move fast because the margin is already leaking. The goal is realized savings before the engagement ends, not a roadmap for someone else to implement.
How the 90 to 120 Day Engagement Works
Three phases. Measurable results at each step. No waiting until the end to see whether it worked.
Phase 1
Rapid Margin Exposure
(Weeks 1 to 3)
We pull the data, map the workflows, and quantify what is leaking and where. No surveys. No intake questionnaires. We work from your actual numbers.
Deliverable: Margin Exposure Report
Phase 2
Recovery Execution and Negotiation
(Weeks 4 to 10)
We execute against the findings. That means payer conversations, vendor renegotiations, process fixes, and A/R recovery work. The goal is realized savings, not a report.
Deliverable: Real Savings
Phase 3
Structural Discipline
(Weeks 10 to 16)
We build the operating cadence and scorecard that keeps the gains from eroding. Standard work, visual accountability, and a monthly review rhythm your team can sustain.
Deliverable: Protection
Where the Margin Is Hiding
These are the five areas we examine in every engagement. Most practices have meaningful exposure in at least three of them.
Revenue Cycle
Billing errors, delayed submissions, denial patterns that nobody is tracking, and A/R aging that has been drifting for months. This is usually the largest single source of recoverable margin.
Operations and Workflow
Redundant steps, manual handoffs, and process gaps that slow throughput and add cost without adding value. Most practices have never mapped these end to end.
Staffing and Scheduling
Suboptimal templates, overtime patterns, and scheduling friction that reduce capacity and increase cost simultaneously. The fix is usually structural, not a headcount decision.
Technology and Vendor Spend
Software contracts on auto-renewal, redundant systems, and IT spend that has never been benchmarked. I have cut IT expense by 40% in a single engagement without losing functionality.
Payer Contracts
Rates that have not been renegotiated in years, carve-outs that were never addressed, and contract terms that are quietly costing you on every claim.
What We Need to Move Fast
Speed requires access. In the first 14 days, we need three categories of data. If that access is restricted or delayed, this engagement is not a fit.
Financial and Revenue
- Trailing 12-month P&L (monthly detail)
- A/R aging and denials by category
- Collections by payer and payer mix
- Provider productivity metrics
Contracts and Vendor Spend
- EHR, MSP, telecom, and software agreements
- Any vendor agreement over $25K annually
- Auto-renewal clauses and subscription inventory
Operational and Throughput
- Appointment templates and staffing roster (FTE)
- Authorization backlog
- Volume and cycle time data
- Call center metrics (if applicable)
Results From Real Engagements
These are not projections. They are outcomes from work done inside physician-owned practices where the consequences were real and the numbers had to hold up.
$1.5M+
Operating expense savings in a single engagement
40%
IT cost reduction through smarter modernization
13%
Overhead reduction without cutting clinical capacity
$1M+
Aged A/R recovered through focused payer work
This Works Well When
- The practice is physician-owned and committed to staying that way
- Annual revenue is between $2M and $20M or more
- Leadership is willing to share data and make decisions
- There is a real sense of urgency around margin or cash flow
- The goal is execution, not a report
This Is Not a Fit When
- ×The goal is comfort rather than clarity
- ×Data access is delayed, restricted, or unavailable
- ×Decisions require months of internal alignment before anything moves
- ×Leadership wants a report rather than a working partner
"If the goal is comfort, this is not a fit. If the goal is margin recovery and structural strength, it is."
The Economics Are Rational
The engagement fee is structured as a fraction of the recoverable value we identify. Most practices see a 5x to 10x return on engagement cost in the first year. Fee structures are available as fixed fee, hybrid, or retainer depending on the scope.
$500K to $2M
Typical recoverable value range
8 to 15%
Fees as a share of first-year recovered value
5x ROI
Minimum target in Year 1